Carstens C, Vetter J, Niethard F U
Stiftung Orthopädische Universitätsklinik Heidelberg.
Z Orthop Ihre Grenzgeb. 1990 Mar-Apr;128(2):174-82. doi: 10.1055/s-2008-1039496.
Among other things the probability of developing a scoliosis in myelomeningocele depends on the patients age, the neurological level of lesion and the localisation of the vertebral arch defect. This study tries to analyse the influence of these factors in 465 patients with MMC and paralytic scoliosis. The results show, that the patients age and the neurological level of lesion are the most important factors for the development of paralytic scoliosis. The statistical evaluation based on the data found permits the determination of regression lines, which allow an estimation of further progression of paralytic scoliosis with respect to the neurological level of lesion and the patients age. At levels of paralysis between Th 3 and Th 12 an average progression of 3.5 degrees per year can be expected. Between L 1 and L 3 the progression rate can be estimated to be 2.5 degrees per year. At levels of paralysis distal to L 3 one can expect to find no significant development of scoliosis. In cases, which exceed the prediction interval, additional intraspinal anomalies, i.e. syringomyelia, must be considered and further examinations including MRI are required.
除其他因素外，脊髓脊膜膨出患者发生脊柱侧弯的概率取决于患者年龄、病变的神经学水平以及椎弓缺损的部位。本研究试图分析这些因素对465例脊髓脊膜膨出合并麻痹性脊柱侧弯患者的影响。结果表明，患者年龄和病变的神经学水平是麻痹性脊柱侧弯发生的最重要因素。基于所获数据的统计评估可确定回归线，从而能够根据病变的神经学水平和患者年龄对麻痹性脊柱侧弯的进一步进展进行估计。在胸3至胸12的麻痹水平，预计每年平均进展3.5度。在腰1至腰3之间，进展速率估计为每年2.5度。在腰3以下的麻痹水平，预计脊柱侧弯不会有显著发展。对于超过预测区间的病例，必须考虑额外的脊髓内异常情况，即脊髓空洞症，并需要进行包括磁共振成像（MRI）在内的进一步检查。
